Abstract 4370568: Beyond Understanding: Trust and Clinician Engagement Drive Willingness to Participate in Research

Background: Despite national efforts to diversify clinical trial populations, participation remains low, particularly among historically underrepresented groups. While educational strategies are often used to address this gap, their impact on actual willingness to participate is not well understood. Objective: To assess whether a brief educational flyer improved understanding, interest, and willingness to participate in clinical trials among 400 adult patients. Methods: We surveyed 400 adults at Mount Sinai clinics and hospitals across New York City. Participants completed questionnaires before and after reviewing an educational flyer about clinical trials. Outcomes included self-reported understanding, willingness, and interest on a 1–5 Likert scale. Demographics included race/ethnicity and education level; ZIP code served as a proxy for socioeconomic status (SES). Logistic regression identified predictors of low willingness (score ≤3). Results: Among participants (31% White, 26% Black, 24% Hispanic, 16% Asian, 3% Other), understanding (+0.84), interest (+0.78), and willingness (+1.20) improved significantly (p < 0.001). Low education (OR 1.90, p < 0.001), low SES (OR 2.74, p < 0.001), and minority race (OR 2.11, p < 0.001) were independent predictors of lower baseline willingness. At baseline, mean willingness scores were lower among Black (2.3) and Hispanic (2.1) participants compared to White (3.4) and Asian (3.3) participants. However, willingness increased most among Black (+1.35) and Hispanic (+1.28) participants. Discussion: An educational flyer is a simple, low-cost intervention that was associated with significant improvements in participants’ willingness to engage in research. Interestingly, the greater increase in willingness suggests that the clinical setting and potential provider endorsement may have amplified its effect. These findings suggest that beyond providing information, fostering trust, particularly through clinician engagement, may play a meaningful role in encouraging participation among underrepresented populations.